Case Presentation: A 35-year-old black male presented to the emergency department (ED) with acute onset diffuse abdominal pain, along with nausea and vomiting. Review of systems was positive for polyuria and polydipsia. The examination was unremarkable apart from a sizeable fungating lesion of the left lower extremity by the ankle measuring 12 x 8 cm. […]

Case Presentation: A previously active 54 year old female with a history of COPD experienced progressive worsening fatigue and two episodes of syncope over the course of 4 months. Transthoracic echocardiography showed a massive 4.9cm x 3.5cm left atrial mass occupying nearly 90% of her left atrium. Four days later she underwent a diagnostic coronary […]

Case Presentation: A 61-year-old male with a past medical history of type 2 diabetes mellitus (T2DM), hypertension, hyperlipidemia, coronary artery disease (CAD) with multiple previous PCIs and status post CABG 6 days prior, presented to the ED with a 1 day history of nausea, vomiting, upper abdominal discomfort and chest pain. He was maintained on […]

Case Presentation: A 61-year-old male with traumatic brain injury, paraplegia and HCV cirrhosis presented with hematemesis secondary to esophageal varices. His course was complicated by aspiration pneumonia and Vancomycin, Aztreonam and Metronidazole were started. On the 6th day of antibiotics, the platelet count dropped from 130K/UL to 3K/UL without signs of clinically significant bleeding. All […]

Case Presentation: An 89-year-old year old woman with a history of type II diabetes mellitus, insulin-naïve and well-controlled on a regimen of metformin, sitagliptin, and dapagliflozin, presented with 3 days of nausea, vomiting, and poor intake of food and liquids. She had recently been prescribed cephalexin for a suspected UTI. She reported a subacute history […]

Case Presentation: A 13 y/o female presented with a 1 month history of painless left inguinal swelling and a 2 day history of worsening inguinal pain, diffuse pruritis, myalgias and fever.  On presentation she was febrile to 103.7oF, tachycardic to 136, and mildly hypotensive.  Exam was notable for a 6cm x7cm area of swelling and […]

Case Presentation: A 58 year-old male with a history of heart and kidney transplantation in 2012, was admitted for a five day history of worsening diarrhea.  Initial workup did not reveal a cause for his symptoms, and his mentation was at baseline.  There was no history of mosquito bites or other exposures.  Following admission, he […]

Case Presentation: 48-year-old-female with the history of Diabetes Mellitus presented with the complain of feeling sick for four-day-duration, chronic diarrhea, and unintentional weight loss of 20 lbs. over a period of two weeks. She was hypotensive with blood pressure 83/42 mmHg, hypothermic with temperature 35 C, tachycardic with the heart rate of 132 and tachypneic […]

Case Presentation: A 37 year old Indian male with no significant past medical history presented to the emergency room complaining of fevers, urinary retention and bilateral lower extremity weakness with pain for 4 days. Travel history was significant for a trip to Kenya 4 weeks prior, where he developed non-bloody diarrhea, fevers and night sweats […]

Case Presentation: A 26-year-old male with a history of schizophrenia presented with generalized abdominal pain and altered mental status. He has a history of multiple psychiatric admissions, specifically seven times in the past two years, and long-term antipsychotic usage. Most recently, he was discharged on clozapine, divaloproex, and trazodone. Initial physical exam was notable for […]